复次， KT 之下左右前后至初步，以五十一字关一百三十六骨，此下至两乳下
分左右，自两足心众骨所会处也。
KT 之下为心蔽骨者一。（无髓。） KT 之左名为胁骨者上下共十二。（居小肠之分也。）
左胁之端，各有胁隐骨者分次亦十二。（无髓。）胁骨之下为季胁骨者共二。（多液。）季胁之
端为季隐骨者共二。（无髓。） KT 之右为肘骨者共十二。（处大肠之分也。）肘骨之下为
肋骨者共二。（各无隐骨，惟兽有之。）右肋之端为肘隐骨者共十二。（无髓。） 骨之前为大
横骨者一。（有势少髓。）横骨之前为白环骨者共二。（有势有液。）白环之前为内辅骨者左右
共二。（有势有液。）内辅之后为骸关骨者左右共二。（有势有液。）骸关之下为犍骨者左右共
二。（有势有液。）犍骨之下为髀枢骨者左右共二。（有势多髓。）髀枢下端膝盖骨者左右共
二。（无势多液。）膝盖左右各有侠升骨者共二。（有势多液。）髀枢之下为 骨者左右共
二。（有势多髓。） 骨之外为辅骨者左右共二。（有势有液。） 骨之下为立骨者左右共
二。（有势有液。）立骨左右各有内外踝骨者共四。（有势少液。）踝骨之前各有下力骨者左右
共十。（有势多液。）踝骨之后各有京骨者左右共二。（有势少液。）下力之前各有释欹骨者共
十。（有势。）释欹之前各有起仆骨者共十。（有
势。）起仆之前各有平助骨者左右各十。（有势。）平助之前各有衬甲骨者左右各十。（无
势少液。）释欹两旁各有核骨者左右共二。（有势多液。）起仆之下各有初步骨者左右共二。
（有势无髓有液，女人则无此骨。）
凡此三百六十五骨也，天地相乘，惟人至灵，其女人则无顶威、骨洞、右棚及
初步等五骨，止有三百六十骨。又男子女人一百九十骨，或隐或衬，或无髓势，余
二百五十六骨并有髓液，以藏诸筋，以会诸脉，溪谷相需而成身形，谓之四大，此骨度之常也。
凡医跌打损伤者，忌用葱，若用葱虽医好，遇天阴伤处必发损作痛。（梁伟士。）
《可法良规》云∶凡伤损之证，乃有形器物所伤，为筋骨受病，当从论。盖血得
热则妄行，其害甚速，须先伐肝火，清运火，砭患处，和经络，则瘀血不致泛注，肌
肉不致遍溃；次则壮脾胃，进饮食，生血气，降阴火，则瘀血易于腐溃，新肉易于
收敛，此要法也。若用克伐之剂，虚者益虚，滞者益滞，祸不旋踵矣。（论瘀血走注。）
又云∶凡伤损之证，若棍扑重者，患处虽不破，其肉则死矣。盖内肉糜烂与瘀
血相和，如皮囊盛糊，然其轻者，瘀血必深蓄于内，宜急砭刺，即投大补之剂，否
则大热烦躁，头目胀痛，牙关紧急，殊类破伤风证，此瘀秽内作而然也，急刺之，诸
证悉退。若刺破之后，或有发热恶寒，口干作渴，怔忡惊悸，寤寐不宁，牙关紧急，
目赤头痛，自汗盗汗，寒战切牙，气短喘促，遗尿手撒，身热脉大，按之如无，身
热不欲近衣，或欲投水，或恶寒而脉浮大，重按微细，衣浓仍寒，此气血挟虚使然也。
皆宜参、 、归、术之类急补之，如不应，速加附子，缓则不救，或手足逆冷，肚腹
疼痛，泻利肠鸣，饮食不入，呃逆呕吐，此寒气乘虚而然也，治法同前用药。如有汗
而不恶寒，或无汗而恶寒，口噤足冷，腰背反张，颈项劲强，乃血气虚而发痉也。治
法亦同前用药，少佐见证之剂，此痉证往往误投风药，以致不起者多矣。若果是破
伤风证，亦系元气耗损，外邪乘虚而致，皆宜峻补先固其本为善。妄投风药，祸如反
掌，治者不可不察。（论瘀秽内 。）
又云∶伤损之证，若内积瘀血， 热宜砭刺，不知砭刺则外皮炙干，缩急坚硬，
已连好肉，不能腐烂，益加胀痛，俗名丁痂皮是也。以致瘀秽难出，治者因将死肉
尽行割去，疮口开张，反难腐溃，怯弱之人，多成破伤风证，以致不救。若杖后刺
去瘀秽，涂以神效当归膏，投以参、术、归、 、地黄之类，诸证即退，死肉即溃，疔
痂不结，所溃亦浅，生肌之际，亦不结痂，自免皱结之痛。（论疔痂皮。）
又云∶凡损伤之证，若皮肤已破，出血过多而昏愦者，气血虚极也，大补为主；
如不应，急加附子。若坠扑太重，皮肤不破，血未出而昏溃者，瘀血在内也，行散
为主；如不应，速加酒炒大黄。若下后而有变证者，皆气血虚极也，用十全大补汤。
若因痛甚而自汗昏愦者，风木炽甚也，用清肝凉血之剂，则痛自定，汗自止，溃自
溃，苟作外因风邪治之，促其危也。（论亡血昏溃。）
又云∶伤损之证，若头脑并致命处所损太重，昏溃良久，将致不起者，急用葱
白细切杵烂，炒热罨患处，稍冷更以热者罨之，多自醒矣。醒而肢体作痛，肌肉被
伤，宜调养气血。若腹中作痛，手不可近者，瘀血停滞也。不可下，宜用花蕊石散
内化之，却以参、 、归、术补托之。
又云∶凡损伤之证，若有瘀血内凝，致大小便不通，若用硝黄苦寒之剂下之，血
愈凝而不下，益加胀满，命在须臾，急用木香、肉桂末二三钱，以热酒灌之，血下
乃生，不下即死。如怯弱之人，欲用硝黄，加木香、肉桂同煎益善，盖假其热以行其寒也。（论瘀血便秘。）
又云∶凡伤损之证，若误饮冷水，瘀
血凝滞，气道不通，或血上逆，多致不救，若入于心即死。急饮童便热酒以和之。若
患重而瘀血不易散者，更和以辛温之剂，睡卧要上身垫高，不时唤醒，勿令熟睡则血
庶不上逆，故患重之人，多为逆血填塞胸间，或闭塞气道，咽喉口鼻不得出入而死。（论瘀血气闭上逆。）
又云∶凡损伤之证，大便秘结。若是出血过多而秘结，此大肠血虚火炽，干燥
而不通耳。不可轻用硝黄峻利之剂，宜用润肠丸，以四物汤送下，或猪胆导法为善。（论血虚便秘。）
又云∶凡伤损之证，胸胁肚腹作痛，按之痛甚者，瘀血在内也，大承气汤下之；既
下而腹痛不止，按之亦痛者，瘀尚未尽也，四物汤加穿山甲、牛膝补而行之。若腹仍
痛，按之却不痛者，血虚也，四物汤加参、 、白术补而和之。若下后脾胃受伤而腹
痛者，补中益气汤为主；下后寒气乘虚而腹痛者，温中益气汤为主；下后昏愦而出
汗者，虚极而变证也，独参汤补之，未应急以大剂人参附子主之，缓则不救。下后
呕吐泻泄，手足厥冷，或指甲青黑者，虚寒之甚也，附子理中汤主之，缓亦不治。若
口噤手撒，遗尿痰盛，或唇青体冷，汗出昏愦，气血虚极之坏证也，非参附汤不能
救，误作风治者必死。（论胸腹作痛。）
又云∶凡伤损之证，若胁胀痛，脉数浮无力，以手按之，反不胀痛者，此血虚
而肝胀也，宜四物汤加参、苓、青皮、甘草治之。若胸胁胀闷或作痛者，按之亦然，
左关脉洪而有力者，此怒气伤肝之证也，以小柴胡汤加芎、归、青皮、赤芍、桔梗、枳
壳治之。若胸胁作胀，按之则愈痛者，乃瘀血蓄肝之证也，急以四物汤加桃仁、红
花、青皮治之。盖证不必论其受责之轻重，问其患处去血之曾否，但被人扭按甚重，蹉
跌扑地，努力恚怒，以伤其气血，瘀血归肝，多致前证，甚则胸胁气逆，胀满不通，
或血溢口鼻，卒至不救。盖打扑坠堕，恶
血宜砭不宜留，况十二经络之血生于心，藏于肝，统于脾，小腹与胁皆肝经部位，恶
血蓄而不行，必生胀满，疼痛，自汗，法当破血生血，清厥阴肝经则善。（论胁胀痛。）
又云∶凡伤损之证，多有患处作痛，若出血过多而痛者，血虚火盛也，宜甘寒以
降虚火，甘温以养脾气。若汗出多而痛者，肝木火盛也，宜辛凉以清肝火，甘寒以生
肝血。若筋骨伤而作痛者，正而治之；肌肉伤而作痛者，调而补之；气血逆而作痛
者，顺而补之；气血虚而作痛者，温而补之。热而痛者清之，寒而痛者温之；阴虚
火痛者用补阴之剂，脾气虚而痛者，用补脾之剂。作脓而痛者托之，脓 而痛者开
之。切不可概用苦寒，以致复伤脾胃也。（论患处作痛。）
又云∶伤损之证，如所伤之处痛至四五日不减者，或至一二日方痛者，皆作脓
也，不必用止痛之药，但宜托里之剂，以速其溃，脓去则痛止。若头目所伤作脓，
赤作痛者，脓出痛亦自止。其或头痛而时作时止者，血虚而痛也，非伤也。若头痛
而兼眩者，火也，痰也，气虚也，木旺也，不可作寒治也。
又云∶凡伤损之证，肉死而不溃，或恶寒而不溃者，宜补阳气。发热而不溃者，
宜益阴血。或因作痛，或因峻剂而不溃者，宜和养脾胃。或因失血，或因汗多而不溃
者，宜大补气血。其外面皮黑坚硬而不溃者，内火蒸炙而然也，内服益阴血，制阳
火之剂；外涂当归膏以润之，则自溃也。大抵脾胃主肌肉，腐溃生肌，全在脾胃气血
两旺，倘治者不识病机，失于补助，故有死肉不能溃而死者；有死肉已溃，新肉不
能生而死者；有死肉溃，新肉生，疮口久不能敛而死者，此三者皆失于不预为补益耳。（论死肉不溃。）
又云∶凡伤损之证，若 痛而肌肉不生者，火盛也；日晡作热而不生者，血虚
也；食少体倦而不生者，脾胃虚也；脓水
清稀而不生者，气血虚也；忌敷生肌长肉之药，恐反助其邪也。若脓多而臭秽者邪
火也，脉洪大而作渴者，其气虚而邪气实也，斯为难治。大抵伤损证候，内无瘀血
即当补脾，脾气得补则肉伤者自愈，肉死者自溃，新肉易生，疮口易合，故云脾健
则肉自生。切不可偏用寒凉克伐之剂，复伤元气，致不能生肌收敛，虽行补益，缓不济事矣。（论新肉不生。）
又云∶凡伤损之证，若壅肿不退，或色黯不消，元气虚也，宜补之；青肿胀痛，
按之复起，脓瘀内滞也，宜针之。经曰∶气主煦之，血主濡之是也。当以六君子汤加
芎、归，培养脾胃元气，则青肿益消，瘀滞自散，脓秽自出。苟服克伐凉剂，虚其
气血，益肿、益青、益溃也。若敷贴寒凉等药，则寒气入里，坠道自壅，瘀血益凝，
运气不至，近死不远。虽壮实之人，亦寒气生热，肉腐深大，气血衰败，肌肉无由
以生，欲望其肿青退，而溃处收敛抑难矣。（论青肿不消。）
又云∶凡伤损之证，若骨已接，骱已入，其肿不消者，此元气怯弱也。怯弱即
不能运散，瘀滞益凝故也。经云∶壮者气行则愈，怯者则着而为病。惟补中益气汤
滋阴助阳，内服十全大补汤，外敷黑龙散，或葱熨之法，则运气健旺，瘀血自救，肿
痛自消。若投行气破血之剂，则元气愈怯，运气愈滞，患在骨骸及血气罕到之处，最
难调治，尤忌寒凉克伐之药。（论肿痛不消。）
又云∶凡伤损之证，口鼻等窍或患处出血不止者，因木火炽盛，血热错经而妄
行也，宜清肝火，养肝血。若中气虚弱，血无所附而妄行者，宜补中益气，使血各归
其经。若阳气内脱，不能摄血归经，而血出不止者，独参汤加炮姜治之，不应则急
加附子。若血蕴于胃而呕血者，四物汤加童便拌炒山栀、姜汁治之。若因怒气伤肝
而呕血者，亦治以前药，更加柴胡、黄芩以清之。如脉大发热喉痛者，参、 、当
归、生地、荆芥、蜜炙黄柏以主之，凡出血脉大者难治。凡见血证，不可用寒凉之
剂，致脾胃受伤，反不能摄血归源也。（论出血呕血便血。）
又云∶凡伤损之证，有出汗者，当审其阴阳虚实而治之。若阴虚阳往乘之，则
发热自汗，以甘寒之剂补其气，如补中益气汤之属是也。若阳虚阴往乘之，则发厥
自汗，以甘温之剂助其阳，如参附汤之属是也。亦有因痛楚而自汗者，宜补气生血
为主。若心孔一片汗出者，养其心血自止。（论出汗。一人年四十，坠马亡血，出汗不止，烦躁不
安。次日其汗遂止，热躁益甚，口噤手颤，此阴血虚，阳火乘之而汗出，为寒气收敛腠理，
故汗不得出，火不得泄，拂郁内甚而益增他证也。若误用祛风之药，愈损气血，促其危矣。）
又云∶凡伤损之证，有发热者，或出血过多，或大溃之后而发热者，乃阴血耗
散，阳气无所根据附，遂致浮散于肌表之间，是为阴虚，非实热也，当归补血汤主之。若
发热烦躁，肉 筋惕等证，乃亡血也，圣愈汤主之。如汗出不止，乃血脱也，急用
独参汤补之。若血脱脉实，汗后脉躁者，难治，细小者易痊。其瘀血内停，必肚
腹作痛，不在此例。（论发热。）
又云∶凡伤损之证，若出血过多，或大溃之后，肌肤发热，大渴引饮，目赤面
红，昼夜不息，其脉洪大而虚，重按全无，此名阴虚发热之病，当归补血汤主之，误
认实热，反用寒凉必死。若身体微热，烦躁面赤，其脉沉而微，此名阴盛发躁之病，
宜四君子汤加姜附治之。《外台秘要》云∶阴盛发躁，欲坐井中，用附子四逆汤加葱
白治之。李东垣亦曰∶切忌寒凉之剂。凡热来复去，不时而动，乃无根虚火也，用
六君子汤加姜、桂，不应急加附子，或八味地黄丸最善。（论发躁。）
Secondly, from below the clavicular fossa (supraclavicular fossa) to the left, right, front, and back down to the initial step (foot), there are fifty-one joints connecting one hundred and thirty-six bones. From below this point to below both breasts, divided into left and right, is where the numerous bones of the soles of the feet converge.
Below the clavicular fossa is one xinbi gu (xiphoid process). (No bone marrow.) To the left of the clavicular fossa are the xie gu (rib bones), twelve in total up and down. (Located in the region corresponding to the small intestine.) At the end of the left ribs, there are xie yin gu (hidden rib bones), also twelve in sequence. (No bone marrow.) Below the rib bones are the ji xie gu (costal margin bones), two in total. (Rich in fluid.) At the end of the costal margins are the ji yin gu (hidden costal bones), two in total. (No bone marrow.) To the right of the clavicular fossa are the zhou gu (elbow bones), twelve in total. (Located in the region corresponding to the large intestine.) Below the elbow bones are the li gu (intercostal/rib bones), two in total. (Each has no hidden bones; only beasts have them.) At the end of the right ribs are the zhou yin gu (hidden elbow bones), twelve in total. (No bone marrow.) In front of these bones is the da heng gu (great transverse bone), one. (Has qi potential, little bone marrow.) In front of the transverse bone are the bai huan gu (white ring bones), two in total. (Has qi potential and fluid.) In front of the white ring bones are the nei fu gu (inner auxiliary bones), two on each side. (Has qi potential and fluid.) Behind the inner auxiliary bones are the hai guan gu (joint gate bones), two on each side. (Has qi potential and fluid.) Below the joint gate bones are the qian gu (knee bones), two on each side. (Has qi potential and fluid.) Below the knee bones are the bi shu gu (thigh pivot bones), two on each side. (Has qi potential, rich in bone marrow.) At the lower end of the thigh pivot bones are the xi gai gu (kneecaps), two on each side. (No qi potential, rich in fluid.) On either side of the kneecaps are the xia sheng gu (flanking ascending bones), two in total. (Has qi potential, rich in fluid.) Below the thigh pivot bones are [bone name missing/corrupted], two on each side. (Has qi potential, rich in bone marrow.) Outside [this bone] are the fu gu (auxiliary/fibula bones), two on each side. (Has qi potential and fluid.) Below [this bone] are the li gu (standing/tibia bones), two on each side. (Has qi potential and fluid.) On either side of the standing bones are the nei wai huai gu (inner and outer ankle bones), four in total. (Has qi potential, little fluid.) In front of each ankle bone are the xia li gu (lower force/metatarsal bones), ten on each side. (Has qi potential, rich in fluid.) Behind each ankle bone are the jing gu (capital bones/cuboid area), two on each side. (Has qi potential, little fluid.) In front of the lower force bones are the shi qi gu (release tilt/wedge bones), ten in total. (Has qi potential.) In front of the release tilt bones are the qi pu gu (rise fall/cuneiform area), ten in total. (Has qi potential.) In front of the rise fall bones are the ping zhu gu (level assist/calcaneus area), ten on each side. (Has qi potential.) In front of the level assist bones are the chen gu jia (cushion bone/joint bones), ten on each side. (No qi potential, little fluid.) On both sides of the release tilt bones are the he gu (nucleus/navicular bones), two on each side. (Has qi potential, rich in fluid.) Below the rise fall bones are the chu bu gu (initial step/tarsal area), two on each side. (Has qi potential, no bone marrow but has fluid; women do not have this bone.)
In total, there are three hundred and sixty-five bones. Heaven and Earth interact, and humans are the most spiritual. Women lack five bones: ding wei, gu dong, you peng, and chu bu, totaling three hundred and sixty bones. Additionally, men and women both have one hundred and ninety bones that are either hidden, cushioned, or lack marrow and qi potential; the remaining two hundred and fifty-six bones all contain bone marrow and fluid, which store the sinews and connect the vessels. The valleys and streams interdepend to form the body shape, called the "Four Greats." This is the standard measurement of bones.
Physicians treating traumatic injuries must avoid using scallions (Cong Bai). If used, even if the injury heals, upon cloudy weather, the injured area will inevitably flare up with pain. (Liang Weishi said.)
The *Kefa Lianggui* states: All injury cases are caused by blunt objects, affecting the tendons and bones, and should be treated according to blood stasis theory. Generally, when blood is heated, it flows recklessly, causing rapid harm. One must first purge Liver Fire and clear the transforming fire, use bian stones (stone acupuncture) to puncture the affected area, and harmonize the meridians, so that blood stasis does not spread and muscles do not ulcerate everywhere. Secondly, strengthen the Spleen and Stomach, promote appetite, generate Qi and Blood, and subdue Yin Fire, so that blood stasis easily decomposes and new flesh easily converges. This is a crucial method. If harsh purgatives are used, the deficient become more deficient, and the stagnant become more stagnant, bringing disaster swiftly. (Discussion on Blood Stasis Migration.)
It further states: In injury cases, if struck heavily by a stick, although the skin may not break, the internal flesh dies. The internal flesh rots and mixes with blood stasis, like paste in a skin bag. In mild cases, blood stasis accumulates deeply internally; urgent stone acupuncture should be performed, followed immediately by strong tonics. Otherwise, severe heat, irritability, head and eye distension/pain, and trismus occur, resembling tetanus. This is due to internal turbid stasis. Urgent puncturing causes all symptoms to recede. If after puncturing, fever, aversion to cold, dry mouth/thirst, palpitations, insomnia, trismus, red eyes/headache, spontaneous/diaphoresis, chattering teeth, shortness of breath, urinary incontinence, hand relaxation, fever with a large pulse that feels empty on deep pressure, feeling hot but wanting to remove clothes or jump into water, or feeling cold with a floating/large pulse that is fine on deep pressure, wearing thick clothes still feels cold, this is due to Qi and Blood deficiency mixed with pathology. Ginseng, [Dang Gui], Shu Di Huang, and Bai Zhu should be used urgently for tonification. If ineffective, add Fu Zi quickly; delay means death. If cold limbs, abdominal pain, diarrhea/borborygmus, inability to eat, belching/vomiting occur, this is Cold Evil invading due to deficiency. Treatment follows previous methods. If sweating without aversion to cold, or no sweating with aversion to cold, trismus, cold feet, opisthotonos, and neck stiffness occur, this is spasm due to Qi and Blood deficiency. Treatment follows previous methods, with slight addition of symptom-specific herbs. Spasm cases are often misdiagnosed as Wind patterns and treated with Wind-dispelling herbs, leading to failure. True tetanus is also due to Yuan Qi depletion and external pathogens invading deficiency; strong tonification to secure the root is best. Misusing Wind-dispelling herbs brings disaster quickly; physicians must examine carefully. (Discussion on Internal Turbid Stasis.)
It further states: In injury cases, if internal blood stasis exists with heat signs, stone acupuncture is indicated. Ignoring this causes the outer skin to dry, shrink, harden, and adhere to healthy flesh, preventing rotting and increasing distension/pain, commonly known as "Ding Jia Pi" (hard scab). This makes turbid stasis difficult to expel. Physicians may excise dead flesh, opening the wound, making rotting harder. Weak patients often develop tetanus and die. After striking, puncture to remove stasis, apply Shen Xiao Dang Gui Gao, and administer Ginseng, Bai Zhu, Dang Gui, [Shu Di Huang], etc. Symptoms recede, dead flesh sloughs, no hard scab forms, ulceration is shallow, and granulation occurs without scarring, avoiding painful contraction. (Discussion on Ding Jia Pi.)
It further states: In injury cases, if skin is broken, bleeding is excessive, and coma ensues, Qi and Blood are extremely deficient; strong tonification is primary. If ineffective, urgently add Fu Zi. If falling/heavy impact breaks no skin, no external bleeding, but coma occurs, blood stasis is internal; moving and dispersing is primary. If ineffective, rapidly add Da Huang stir-fried in wine. If post-purgation changes occur, Qi and Blood are extremely deficient; use Shi Quan Da Bu Tang. If severe pain causes spontaneous sweating and coma, Wood/Fire is blazing; use Liver-clearing and Blood-cooling herbs. Pain stops, sweat stops, ulceration proceeds naturally. Treating as external Wind accelerates danger. (Discussion on Blood Loss Coma.)
It further states: In injury cases, if the head or vital areas are severely damaged, causing prolonged coma threatening death, urgently chop Cong Bai finely, pound it, stir-fry until hot, and apply to the site. Replace with fresh hot compresses as it cools; consciousness usually returns. If awake with limb pain and muscle injury, nourish Qi and Blood. If abdominal pain prevents touching, blood stasis stagnates. Do not purge; use Hua Rui Shi San internally to resolve it, then tonify with Ginseng, [Dang Gui], Shu Di Huang, and Bai Zhu.
It further states: In injury cases, if internal blood stasis causes constipation, using bitter-cold laxatives like Xiao Shi and Da Huang causes blood to congeal further, worsening distension, leading to imminent death. Urgently use Mu Xiang and Rou Gui powder (2-3 qian) with hot wine. If blood moves, life is saved; if not, death ensues. For weak patients desiring Xiao Shi/Da Huang, adding Mu Xiang and Rou Gui during decoction is better, borrowing their heat to move the cold herbs. (Discussion on Blood Stasis Constipation.)
It further states: In injury cases, drinking cold water causes blood stasis to congeal, blocking Qi channels, or blood rebels upward, often fatal, especially if entering the Heart. Urgently drink Tong Bian (child urine) and hot wine to harmonize. For severe cases where stasis is hard to disperse, add acrid-warm herbs. Sleep with upper body elevated, wake frequently to prevent deep sleep, so blood does not rebel. Severe cases often die from blood filling the chest, blocking airways. (Discussion on Blood Stasis Rebellious Qi Blockage.)
It further states: In injury cases, constipation. If due to excessive bleeding, it is Large Intestine Blood deficiency with blazing fire, causing dryness. Do not lightly use harsh laxatives like Xiao Shi/Da Huang. Use Run Chang Wan delivered with Si Wu Tang, or Pig Gallbladder suppository method is best. (Discussion on Blood Deficiency Constipation.)
It further states: In injury cases, chest/hypochondrium/abdominal pain worsened by pressure indicates internal blood stasis; purge with Da Cheng Qi Tang. If pain persists after purging and is tender to touch, stasis remains; use Si Wu Tang plus Chuan Shan Jia and Niu Xi to tonify and move. If abdomen hurts but is not tender to touch, it is Blood deficiency; use Si Wu Tang plus Ginseng, [Dang Gui], and Bai Zhu to tonify and harmonize. If post-purgation Spleen/Stomach injury causes pain, use Bu Zhong Yi Qi Tang. If post-purgation Cold invasion causes pain, use Wen Zhong Yi Qi Tang. If post-purgation coma and sweating occur, extreme deficiency with transformation; use Du Shen Tang. If urgent, large doses of Ginseng and Fu Zi; delay means death. Post-purgation vomiting/diarrhea, cold limbs, blue-black nails indicate extreme deficiency-cold; use Fu Zi Li Zhong Tang. Delay is untreatable. Trismus, hand relaxation, urinary incontinence, phlegm, blue lips, cold body, sweating/coma indicate extreme Qi/Blood deficiency collapse; only Shen Fu Tang can save. Mistaking for Wind leads to death. (Discussion on Chest/Abdominal Pain.)
It further states: In injury cases, hypochondriac distension/pain, rapid/floating/weak pulse, non-tender to pressure indicates Blood deficiency with Liver distension; use Si Wu Tang plus Ginseng, Fu Ling, Qing Pi, and Gan Cao. If chest/hypochondriac fullness/pain, tender to pressure, left Guan pulse surging/strong indicates Anger injuring Liver; use Xiao Chai Hu Tang plus Xiong Diao, Dang Gui, Qing Pi, Chi Shao, Jie Geng, and Zhi Ke. If chest/hypochondriac distension worsens with pressure, blood stasis accumulating in Liver; urgently use Si Wu Tang plus Tao Ren, Hong Hua, and Qing Pi. Severity of beating or bleeding doesn't matter; twisting, falling, or anger injures Qi/Blood, sending stasis to Liver, causing these symptoms. Severe cases involve rebellious Qi, distension, epistaxis/hematemesis, sudden death. Blunt trauma stasis requires puncturing, not retention. Blood is generated in Heart, stored in Liver, controlled by Spleen; hypogastrium/hypochondrium are Liver channel regions. Retained stasis causes distension/pain/sweating; method is to break and generate blood, clear Jueyin Liver channel. (Discussion on Hypochondriac Distension/Pain.)
It further states: In injury cases, local pain. If excessive bleeding causes pain, it is Blood deficiency with blazing fire; use sweet-cold to descend false fire, sweet-warm to nourish Spleen Qi. If profuse sweating causes pain, Liver Wood fire is blazing; use acrid-cold to clear Liver fire, sweet-cold to generate Liver Blood. If tendon/bone injury causes pain, treat directly; if muscle injury, regulate and tonify; if Qi/Blood rebellion causes pain, smooth and tonify; if Qi/Blood deficiency causes pain, warm and tonify. Heat pain clears it; Cold pain warms it; Yin deficiency fire pain uses Yin-tonifying herbs; Spleen Qi deficiency pain uses Spleen-tonifying herbs. Suppuration pain uses expulsion; mature pus pain uses drainage. Never indiscriminately use bitter-cold herbs to spare the Spleen/Stomach. (Discussion on Local Pain.)
It further states: Injury pain lasting 4-5 days unchanged, or starting 1-2 days later, indicates suppuration. No need for analgesics; use interior-expelling herbs to accelerate rupture. Pain stops when pus exits. Head/eye injury suppuration with redness/pain stops when pus exits. Intermittent headache is Blood deficiency pain, not injury. Headache with dizziness is Fire, Phlegm, Qi deficiency, or Liver Yang hyperactivity; do not treat as Cold.
It further states: In injury cases, dead flesh not ulcerating or aversion to cold preventing ulceration requires tonifying Yang Qi. Fever preventing ulceration requires nourishing Yin Blood. Pain or harsh drugs preventing ulceration requires harmonizing/nourishing Spleen/Stomach. Blood loss or profuse sweating preventing ulceration requires strong Qi/Blood tonification. Black/hard skin not ulcerating is due to internal fire baking; internal Yin-nourishing/Yang-suppressing herbs, external Dang Gui Gao application causes natural ulceration. Spleen/Stomach governs flesh; rotting/granulation depends on robust Spleen/Stomach Qi/Blood. Failure to tonify leads to death from non-ulcerating dead flesh, non-granulating ulcers, or non-healing wounds. These result from lack of preventive tonification. (Discussion on Dead Flesh Not Ulcerating.)
It further states: In injury cases, pain with no granulation indicates blazing fire; afternoon fever with no granulation indicates Blood deficiency; poor appetite/fatigue with no granulation indicates Spleen/Stomach deficiency; thin pus with no granulation indicates Qi/Blood deficiency. Avoid topical granulation herbs as they may aid pathogenic factors. Profuse foul pus indicates pathogenic fire; surging pulse with thirst indicates Qi deficiency with excess pathogen; this is difficult. Generally, if no internal stasis, tonify Spleen. Tonified Spleen heals injured flesh, ulcerates dead flesh, generates new flesh, closes wounds. "Spleen healthy, flesh grows." Avoid cold/purging herbs to spare Yuan Qi. Slow tonification fails. (Discussion on New Flesh Not Growing.)
It further states: In injury cases, swelling not subsiding or dark discoloration indicates Yuan Qi deficiency; tonify. Blue-green swelling/pain rebounding to pressure indicates internal pus/stasis; puncture. Classics say: Qi warms, Blood moistens. Use Liu Jun Zi Tang plus Xiong Diao and Dang Gui to cultivate Spleen/Stomach Yuan Qi; swelling subsides, stasis disperses, pus exits. Purging/cold herbs worsen deficiency, swelling, cyanosis, and ulceration. Topical cold herbs drive Cold inward, blocking pathways, congealing stasis, stopping circulation, nearing death. Even strong individuals suffer deep rot, Qi/Blood decline, and failed healing. (Discussion on Persistent Swelling/Cyanosis.)
It further states: In injury cases, if bones are set and joints reduced but swelling persists, Yuan Qi is weak. Weakness fails to circulate, congealing stasis. Classics say: Strong people heal via Qi movement; weak people develop disease. Use Bu Zhong Yi Qi Tang to nourish Yin/assist Yang, internal Shi Quan Da Bu Tang, external Hei Long San, or Cong Yun (scallion moxibustion) to strengthen circulation, allowing self-resolving stasis and swelling. Moving/Qi-breaking herbs weaken Yuan Qi and circulation. Injuries in bony areas with scarce Qi/Blood are hardest to treat; avoid cold/purging herbs. (Discussion on Persistent Swelling/Pain.)
It further states: In injury cases, unceasing bleeding from orifices/wounds due to blazing Wood/Fire and Heat disturbing vessels; clear Liver fire, nourish Liver Blood. Middle Qi deficiency causing unattached blood; tonify Middle Qi to guide blood to vessels. Internal Yang collapse failing to control blood; Du Shen Tang plus Pao Jiang. If ineffective, urgently add Fu Zi. Blood pooling in Stomach causing hematemesis; Si Wu Tang plus Tong Bian stir-fried with Zhi Zi and Jiang Zhi. Anger injuring Liver causing hematemesis; same formula plus Chai Hu and Huang Qin. Large pulse, fever, sore throat; Ginseng, [Shu Di Huang], Dang Gui, Sheng Di, Jing Jie, Mi Zhi Huang Bo. Large pulse in bleeding is difficult. Never use cold herbs in bleeding to spare Spleen/Stomach from failing to control blood. (Discussion on Bleeding/Hematemesis/Melena.)
It further states: In injury cases, sweating. Assess Yin/Yang/Deficiency/Excess. Yin deficiency with Yang invading causes fever/spontaneous sweating; use sweet-cold to tonify Qi, e.g., Bu Zhong Yi Qi Tang. Yang deficiency with Yin invading causes syncope/spontaneous sweating; use sweet-warm to assist Yang, e.g., Shen Fu Tang. Pain-induced sweating requires tonifying Qi/generating Blood. Sweat on heart center stops by nourishing Heart Blood. (Discussion on Sweating. Case: 40yo male fell from horse, lost blood, continuous sweating, irritability. Next day sweat stopped, heat/irritability worsened, trismus/tremors. Yin Blood deficiency, Yang fire invading. Cold constricts pores, trapping fire/sweat, causing internal stagnation and other symptoms. Misusing Wind herbs damages Qi/Blood, accelerating danger.)
It further states: In injury cases, fever. After excessive bleeding or major ulceration, fever indicates Yin Blood depletion, leaving Yang unanchored and floating on surface; this is Yin deficiency, not Excess Heat; use Dang Gui Bu Xue Tang. Fever, irritability, muscle twitching indicates blood loss; use Sheng Yu Tang. Continuous sweating indicates Blood collapse; urgently use Du Shen Tang. Blood collapse with solid pulse, restless pulse after sweating is difficult; fine/small pulse recovers easily. Internal stasis causes abdominal pain, excluded here. (Discussion on Fever.)
It further states: In injury cases, after excessive bleeding/major ulceration, skin fever, intense thirst, red eyes/face, day/night persistence, surging/empty pulse vanishing on deep pressure is Yin deficiency fever; use Dang Gui Bu Xue Tang. Mistaking for Excess Heat and using cold herbs is fatal. Mild fever, irritability/red face, sinking/faint pulse is Yin excess with agitation; use Si Jun Zi Tang plus Jiang/Fu Zi. *Waitai Miyao* says: Yin excess agitation, desire to sit in well; use Fu Zi Si Ni Tang plus Cong Bai. Li Dongyuan says: Avoid cold herbs. Intermittent heat is rootless false fire; use Liu Jun Zi Tang plus Jiang/Gui, or Ba Wei Di Huang Wan. Urgent Fu Zi is not needed. (Discussion on Agitation.)